My First On-Night Experience In Nursery Ward

Nursery.

The ward where babies are admitted with mothers immediately post delivery or at least a day or two after delivery before the mother is being discharged.

Prior to serving my time in Nursery, I was working in the General Ward for 2 months, otherwise known as Paediatrics 2B.

Occasionally, I will have to cover Nursery for a day per week but rarely.

The “On-Night” shift in the Nursery begins from 7pm till 10am the following day. Well, in reality, we don’t actually go back by 10am, it’s usually 11am or 12pm at the latest.

I was allocated to work with a colleague I had known back in the Orthopaedics Posting.

Prior to my night shift with her, she had done multiple “on-night’s” in the Nursery ward and was familiar with “resuscitation“.

Thus, for my first night, I offered to tank the nursery ward while she handled resuscitation.

While working the night shift in the nursery ward, one house officer has to be in charged of resuscitation or at least the main resuscitator while the other is the “second call” or the one who does the active joblists in the ward.

That was the decision we agreed upon prior to starting our shift. Upon arrival, her phone started going off while I tended to the time-sensitive bloods and started reviewing the “obs bay” cases. “Obs bay” or observatory bay is where the newly admitted babies will be located. It is also somewhat known as the “acute bay” of nursery. However, it does not always mean that the babies admitted here are unstable, most of the time, they are discharged after a few hours or subsequently moved to other cubicles.

During my first night shift in the Nursery, my phone rang only once for a referral of which I passed on to my partner since I have yet to attend a resuscitation of my own.

Thus, any babies that were admitted, I transferred them in, carried out the active plans, take bloods if necessary, traced the bloods, updated the medical officers, requested for bloods for transfusion for a baby in NICU, having a light meal and then finally going to sleep in the breastfeeding room.

The breastfeeding room is where the mothers sit when they visit their babies and well, breastfeed. Since we do not have a room of our own, we sleep over there. My friend advised me to sleep while we get the chance since we will need to follow rounds in the postnatal ward for baby check the following day.

We managed to get a good 1 hour plus nap before my friend’s alarm went off and woke me up. Being a light sleeper, it was difficult for me to go back to sleep. Thus, we decided to get an early start on tracing the morning joblists for the babies in postnatal ward.

The baby checks were usually done in Maternity 1 and Maternity 3. There are times if there are too many deliveries overnight and no more beds in Maternity 3, they may overflow to Maternity 2.

We started off in Maternity 1, compiled all the “baby books” and traced the G6PD status as well as the cTSH in the system if it is yet to be traced, trace any serum bilirubin if it was taken, tick and sign the page stating that the mother needs to register the child upon discharge, go for follow up vaccinations and basic care of the child.

After we are done with Maternity 1, we went to Maternity 3. Considering that there are about 50 patients, we took some time before we were done.

During weekdays, the medical officers from the Nursery Ward complete their reviews and rounds first in Nursery prior to “baby check”. During weekends, usually only 1 medical officer is allocated for all the “baby checks”.

Around 9am, a sea of medical officers arrived and proceeded with “baby check”. “Baby check” is a systemic examination from head to toe to look for any abnormalities such as heart murmur, ambiguous genitalia, undescended testes, imperforate anus, just to name a few.

After which, they will sign and chop the baby check page. If the child has already been checked previously, usually the child is checked for any jaundice and if it is suggestive, a TCB will be done to check the phototherapy level followed by the commencement of the phototherapy.

Occasionally, the baby may appear jaundice after a few hours after birth and for that, we would need to send a “Day 1 Jaundice” workup.

There are some babies who are admitted in the postnatal ward for phototherapy. Usually, the mother has already been discharged and we call them “DAB” or “Discharged Awaiting Baby” as the child is under phototherapy. For this, an “SB” or serum bilirubin will usually be taken by the nurses and sent around 4am.

In the morning around 7-8am, the results would already be out by then. Most of the time, they are either continued or discontinued from phototherapy. In rare cases, they are escalated to biliblanket or double phototherapy.

After the rounds are complete, it is time to go about carrying out the active joblists. This involves referrals if necessary, sometimes to physiotherapist, occupational therapist, surgical department or dental if any, taking bloods and sending them or transferring babies out to Nursery to be admitted.

After completion of all these, then only we will start making our way back which on average is around 11am to 12pm. For my first “on-night” shift, I went back around 11:30 am.

It was a good first experience, especially since I have an excellent partner to guide me and to help me out.

If you have yet to work the night shift in Nursery, it is actually quite fun. Albeit it being tiring due to the long hours.

YouTube | Instagram | Pinterest | Facebook | Spotify

About Me | Privacy Policy | Contact Me

My First On-Night Experience In Nursery Ward

Published by Dr. Jewel Nambiar

Leave a comment Cancel reply

Share this:

Published by Dr. Jewel Nambiar

Leave a comment Cancel reply